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Suggest Treatment For Idiopathic Thrombocytopenic Purpura

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Posted on Tue, 10 Feb 2015
Question: Dear doctor, I am 47 years old, 68 kg and 155 cm height. i am diagonised with ITP from one year and medicine given is omnacortil 5mg daily. Disorder was found with my spleen. But the medicine is having its side effects. what are natural subsititues available for the medicine which i am taking at present. Is there any other medicine available in market for ITP with minimum side effects or no side effects. My present level of platelets count is above one lac but decreases on stopping the medicine. thanks


doctor
Answered by Dr. Jyothi B L (27 minutes later)
Brief Answer:
Try slow dosage reduction. Abrupt stopping, not advisable.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Jyothi BL and I will be answering your query.

Based on your query, my opinion is as follows:

1. If the platelet count is above 1 lakh, slow reduction of omnacortil, should negate any further fall in platelet count. Abrupt stopping of omnacortil should be stopped. Slow dosage change over month should be tried.
2. Side effects, at this dose is rarely seen. Do mention the side effects, and i will try to assess it. Usually mild weight gain is common.
3. Splenectomy would be next better option.
4. Other options available are more complicated and have more adverse reactions than omnacortil (prednisolone) being given. You can try changing brand, but same dose, if its going to help.

Hope it helps.
Any further queries, happy to help again.

Dr. Jyothi BL
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Jyothi B L (49 minutes later)
Dear doctor,

omnacotil was stopped after gradually reducing it to alternate days. side effects

include weight gain, depression and erectile dyfunction. When the platelet level was reached @ 10000, at that time the dose was quite high and now it is reduced after platelet levels crossed one lac.My sexual activity is reactivated when the medicine dose is stopped. But the platelet count starts decreasing within a period of two to three weeks after stopping the medicine.

Hence i was asking for substitute for omnacortil so that i can continue taking the medicine and lead a normal married life. thanks,
doctor
Answered by Dr. Jyothi B L (2 hours later)
Brief Answer:
20,000 platelet count is also ideal for you.

Detailed Answer:
Hi,
Thanks for asking again.

You can try:
1. Reducing omnacortil dose slowly. If platelet count remains above 20,000 at all times, and does not fall below it, not to worry. This conservative approach is better. If it falls below 20,000 - restart medication and --
2. Splenectomy - Ideal choice for chronic ITP. Spleen is the site of destruction. Need to maintain a healthy life. Avoid certain infections and get proper immunization. No risk.
3. Immunosuppresants like Azathioprine or vinblastine can be used in place of prednisone.

I would suggest you to try the first option. If it does not workout, then second or third option is dependent upon you.

For prescription, you need to meet your doctor.

Hope it helps.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Jyothi BL
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
Dr.
Dr. Jyothi B L

Pathologist and Microbiologist

Practicing since :2003

Answered : 849 Questions

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Suggest Treatment For Idiopathic Thrombocytopenic Purpura

Brief Answer: Try slow dosage reduction. Abrupt stopping, not advisable. Detailed Answer: Hi, Thanks for asking. I am Dr. Jyothi BL and I will be answering your query. Based on your query, my opinion is as follows: 1. If the platelet count is above 1 lakh, slow reduction of omnacortil, should negate any further fall in platelet count. Abrupt stopping of omnacortil should be stopped. Slow dosage change over month should be tried. 2. Side effects, at this dose is rarely seen. Do mention the side effects, and i will try to assess it. Usually mild weight gain is common. 3. Splenectomy would be next better option. 4. Other options available are more complicated and have more adverse reactions than omnacortil (prednisolone) being given. You can try changing brand, but same dose, if its going to help. Hope it helps. Any further queries, happy to help again. Dr. Jyothi BL